ACNE

NURSING MANAGEMENT OF PATIENTS WITH
INTEGUMENTARY SYSTEM
Prepared By:
Mr. Shreyas S. Walvekar
Ph.D. Research Scholar
KINS, Karad
ACNE
WHAT IS ACNE ?
• Acne is a common disorder of pilosebaceous (hair and sebaceous) structure, as they
opens to the skin surface through pore.
• Acne Vulgaris is a common and chronic skin disorder of the pilosebaceous unit that
primarily affects the face, chest, and back.
WHAT ARE THE CAUSES AND RISK FACTORS?
• Excessive sebum production
• Irregular shedding of dead skin cells
• Build-up of bacteria
• Abnormal keratinization of follicular epithelium
• Increased androgen production
• Change in hormones during puberty, menstrual cycles

• Genetic Family history.
• Overactivity/ hyperresponsiveness of sebaceous glands
• Inflammation, including innate and induced immune responses
• Industrial exposure to halogenated hydrocarbons
• Adolescence
• Hair gels or oil-based cosmetics
• Sports equipment such as helmet straps
• Medications with iodine, found in some cough medicines
• Certain prescription drugs: lithium, isoniazid, phenytoin, corticosteroids

WHAT ARE THE TYPES OF ACNE VULGARIS?
• Non-inflammatory Acne Very mild acne vulgaris (appearance of Comedo (whiteheads and
blackheads)
• Inflammatory Acne (Includes appearance of papules, pustules, and macules)
• Cystic Acne (appearance of cysts and nodules)

PATHOPHYSIOLOGY
Sebaceous glands stimulated by various factors
They secrete sebum to a skin surface
Increase shedding of epithelial cell linning
Pilosebaceous ducts got plugged
Cutaneous flora multiply
Inflammatory response to follicle
Formation of open and closed comodones

WHAT ARE THE CLINICAL MANIFESTATIONS ?
• Lesions form on face, neck, back, chest and shoulders
• Spots that have become inflamed may be painful, tender to touch and affected skin feel hot.
• Comedo: as whiteheads or blackheads
• Papules and pustules
• Nodules
Severe cases
• Cysts (darkening of skin and severe scarring also occurs.)
• Abscesses, draining sinuses, fistulated comedones, and keloidal and atrophic scars.
HOW WE CAN MANAGE ?
• Treatment directed at reducing sebum production, comedone formation, inflammation, and
bacterial counts.
1. Over-the-counter topical treatments:
• benzoyl sulfur, resorcinol, salicylic acid or sulfur as their active ingredient.
2. Topical treatments available by prescription:
• Tretinoin (Avita, Retin-A, others), adapalene (Differin) and tazarotene (Tazorac, Avage).
3. Antibiotics
4. Isotretinoin is a powerful medication available for scarring cystic acne or acne that
doesn't respond to other treatments.
5. Oral contraceptives (a combination of norgestirol and ethinyl estradiol )
6. Laser and light therapy (deeper layers of skin without harming the skin's surface.)
7. Cosmetic procedures (Chemical peels and microdermabrasion)

WHAT IS ACNE ROSACEA?
• It is a chronic rash skin disorder limited to the nose, cheeks, chin, and forehead,
typically beginning during adulthood.
• It is characterized by erythema, papules, pustules and tetangiectases occurs on face

especially the nose.
WHAT ARE THE CAUSES AND RISK FACTORS ?
• The exact cause is not known
• A tiny mite, demodex folliculorum
• Fair skin, blue eyes and of Celtic
• Chronic exposure to ultraviolet radiation
• Tea and coffee, alcohol,
• Exposures to extreme cold and heat
• Hot spicy foods
• Emotional stress
• Abnormal immune reactions in the skin

WHAT ARE THE CLINICAL MANIFESTATIONS ?
• Symptoms may vary from person to person
• Facial skin (oily, reddened and bumpy, dry, flaky)
• Flushing on forehead, nose and cheeks
• Pustules & papules
• Red, itchy and sore eyes and eyelids
• Sensitive skin that may burn, sting or itch
• A swollen and bumpy nose

Chronic cases:
• Skin color changes to dark red and pores become enlarged and sebaceous hyperplasia of
nose (rhinophyma) present.
HOW WE CAN MANAGE?
• There is no permanent cure for rosacea.
1. General Measures:
• Avoid strong sunlight to the face.
• Sunlight is thought to make symptoms worse.
• Use a sunblock cream on the face, with a high protection factor (30 or higher and with
ultraviolet A and ultraviolet B protection)
2. Oral Antibiotics:
• Tetracycline antibiotics including doxycycline and minocycline reduce inflammation. (6-12 wks)
3. Anti-inflammatory Agents:
• Oral non-steroidal anti-inflammatory agents such as diclofenac may reduce the discomfort and
redness of affected skin.
4. Topical Treatment:
• Metronidazole in combination with oral antibiotics for more severe cases.
• Azelaic acid cream or lotion, applied twice daily to affected areas.

5. Laser treatment:
• Laser treatment can be very effective if have visible blood vessels and can also sometimes be
used for flushing.
NURSING MANAGEMENT
1. Impaired Skin Integrity may be related to secretions, infectious process as evidenced by
disruptions of skin surface.
2. Disturbed Body Image may be related to change in visual appearance, as evidenced by fear of
rejection of others, focus on past appearance, negative feelings about body, and change in social
involvement.
3. Situational low Self-Esteem may be related to adolescence, negative perception of

appearance, as evidenced by self-negating verbalizations, expressions of helplessness.

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NURSING MANAGEMENT OF PATIENTS WITH

• Excessive sebum production

• Irregular shedding of dead skin cells

• Abnormal keratinization of follicular epithelium

• Increased androgen production

• Change in hormones during puberty, menstrual cycles

• Overactivity/ hyperresponsiveness of sebaceous glands

• Inflammation, including innate and induced immune responses

• Industrial exposure to halogenated hydrocarbons

• Hair gels or oil-based cosmetics

• Sports equipment such as helmet straps

• Medications with iodine, found in some cough medicines

• Certain prescription drugs: lithium, isoniazid, phenytoin, corticosteroids

• Inflammatory Acne (Includes appearance of papules, pustules, and macules)

• Cystic Acne (appearance of cysts and nodules)

They secrete sebum to a skin surface

Increase shedding of epithelial cell linning

Pilosebaceous ducts got plugged

Cutaneous flora multiply

Inflammatory response to follicle

Formation of open and closed comodones

• Comedo: as whiteheads or blackheads

• Papules and pustules

• Cysts (darkening of skin and severe scarring also occurs.)

1. Over-the-counter topical treatments:

• benzoyl sulfur, resorcinol, salicylic acid or sulfur as their active ingredient.

2. Topical treatments available by prescription:

5. Oral contraceptives (a combination of norgestirol and ethinyl estradiol )

7. Cosmetic procedures (Chemical peels and microdermabrasion)

• It is characterized by erythema, papules, pustules and tetangiectases occurs on face

• A tiny mite, demodex folliculorum

• Fair skin, blue eyes and of Celtic

• Chronic exposure to ultraviolet radiation

• Tea and coffee, alcohol,

• Exposures to extreme cold and heat

• Hot spicy foods

• Abnormal immune reactions in the skin

• Symptoms may vary from person to person

• Facial skin (oily, reddened and bumpy, dry, flaky)

• Flushing on forehead, nose and cheeks

• Pustules & papules

• Red, itchy and sore eyes and eyelids

• Sensitive skin that may burn, sting or itch

• A swollen and bumpy nose

• Avoid strong sunlight to the face.

• Sunlight is thought to make symptoms worse.

• Metronidazole in combination with oral antibiotics for more severe cases.

• Azelaic acid cream or lotion, applied twice daily to affected areas.

3. Situational low Self-Esteem may be related to adolescence, negative perception of

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